2.06 Skin Pathology

Question 1

Sebaceous glands, hair follicles, and sweat glands are contained in what layer of the skin

Answer 1

Dermis

Question 2

What is the characteristic histologic appearance of squamous cell carcinoma

Answer 2

keratin pearls

Question 3

Risk factor for malignant melanoma

Answer 3

Sun exposure

Question 4

Most common malignant skin tumor

Answer 4

Basal cell carcinoma

Question 5

Cell of origin of basal cell carcinoma

Answer 5

Keratinocyte precursor in the basal cell layer

Question 6

Melanocytic hyperplasia of the basal layers of the epidermis; clinical presentation is a brown pigmented spot on the skin

Answer 6

Lentigo

Question 7

This occurs due to an increase in the number of melanocytes that form clusters

Answer 7

Melanocytic Nevi

Question 8

in comparing junctional nevus from dermal nevus, junctional nevus is appears ___ (pigmentaiton and elevation)

Answer 8

Junctional nevus: less pigmented, generally flat

Question 9

in comparing junctional nevus from dermal nevus, dermal nevus is appears ___ (pigmentaiton and elevation)

Answer 9

dermal nevus: more pigmented and elevated

Question 10

Urticaria is due to what type of hypersensitivity

Answer 10

Hypersensitivity Type I, IgE mediated

Question 11

Acute Eczematous Dermatitis is due to what type of hypersensitivity

Answer 11

Hypersensitivity Type IV

Question 12

What is the characteristic gross lesion of erythema multiforme

Answer 12

Target lesion

Question 13

Severe for of erythema multiforme; febrile, often in children, with extensive involvement of the skin and mucosal surfaces; epidermal detachment is less that 30%

Answer 13

Steven Johnson syndrime

Question 14

Severe for of erythema multiforme with diffuse necrosis and peeling of skin and mucosal surfaces

Answer 14

Toxic epidermal necrolysis

Question 15

This condition is characterized by the hyperproliferation of epidermis and abnormal keratinization due to faster turnover time of epidermal keratinocytes; there is accumulation of cells in the stratum corneum that leads to scaling

Answer 15

Psoriasis

Question 16

Psoriasis is usually found in what areas of the body

Answer 16

Extensor surfaces of the elbows, knees
Scalp
Lumbosacral areas

Question 17

__ sign is the punctate bleeding seen when capillary loops are exposed when the epidermis is scratched in patients with psoriasis

Answer 17

Auspitz sign

Question 18

Test tube appearance in psoriasis is due to ___

Answer 18

elongation of rete pegs

Question 19

6 P’s of Lichen Planus

Answer 19

Pruritic, purple, polygonal, planar, papules and plaques

Question 20

Typical locations of lichen planus

Answer 20

Flexor surfaces
inner chest
genitalia
buccal mucosa

Question 21

Histologic appearance of lichen planus

Answer 21

bandlike infiltration of lymphocytes at the dermoepidermal junction, hyperkeratosis, and saw tooth pattern of rete pegs

Question 22

Location of seborrheic dermatitis

Answer 22

Regions with high density of sebaceous glands (forehead, scalp, external auditory canal)

Question 23

Gross clinical presentation of seborrheic dermatitis

Answer 23

macules and papules on an erythematous-yellow, greasy base, with scaling and crusting, fissures, dandruff,

Question 24

__ is a blistering disorder caused by autoantibodies that result in the dissolution of intercellular attachments within the epidermis and mucosal epithelium

Answer 24

Pemphigous

Question 25

State the pathology and lesion involved in pemphigus vulgaris

Answer 25

Etiology: Autoantibodies (IgG) against Dsg1 and Dsg3 Acantholysis with intraepidermal bullae Lesion: blisters in the deep suprabasal epidermis

Question 26

State the etiology and lesion found in pemphigous foliaceus

Answer 26

Etiology: Autoantibodies against Dsg1 alone Lesion: superficial subcorneal blisters

Question 27

State the etiology and lesion in bullous pemphigoid

Answer 27

Etiology: Autoantibodies bind BPAG2 ( component of the hemidesomes) Lesion: blister formation at the level of the lamina lucida of the BM.

Question 28

State the pathogenesis and lesion involved in dermatitis herpetiformis

Answer 28

IgA antibodies are developed against dietary gluten. the antibodies cross-react with reticulin (component of fibrils that anchor hemidesmosomes to the dermis) leading to early dermoepidermal separation Lesion: subepidermal blister

Question 29

Appearance of epidermolysis bullosa

Answer 29

blisters at sites of pressure, rubbing or trauma, or in flexural creases

Question 30

Location of lesions of dematitis herpetiformis

Answer 30

Bilateral symmetric and grouped vesicles at extensor surfaces, elbows, knees

Question 31

Acute dermatosis is characterized primarily by infiltration of ___

Answer 31

lymphocytes and macrophages

Question 32

What is the severe form of erythema multiforma which is usually in febrile form in children, with extensive involvement of skin and mucosal surfaces, epidermal detachment occuers in less than 10% of cases

Answer 32

Steven Johnson Syndrome

Question 33

Characterize lesion and location of lesion in psoriasis

Answer 33

Epidermal hyperplasia, parakeratotic scale, and accumulation of neutrophils within the superficial epidermis Located in extensor surfaces of elbows and knees, scalp, and lumbosacral areas

Question 34

Lichen planus is located at___

Answer 34

the flexor surfaces and inner chest, genitalia, and buccal mucosa

Question 35

Appearance of immunofluorescence of pemphigous vulgaris

Answer 35

chicken-wire appearance or netlike pattern of intercelllar IgG deposits along the plasma membranes of epidermal keratinocytes, which shows suprabasal separation

Question 36

Appearance of immunofluorescence of bullous pemphigoid

Answer 36

Antibody deposition occurs in a continuous linear (ribbon-like) pattern at the dermoepidermal junction

Question 37

Patients with celiac disease develop IgA antibodies that react to reticulin which a component of fibrils that anchor hemidesmosomes which leads to ___ in ___ disease

Answer 37

dermoepidermal separation in DERMATITIS HERPETIFORMIS

Question 38

State pathology in pemphigous vulgaris

Answer 38

acantholysis with intraepidermal bullae, atnibodies to keratinocyte antigens which are involved in intercellylar attachment Lesion: blisters in the deep suprabasal epidermis

Question 39

Identify lesion: intercellular edema of epidermis resulting to increased space between keratinocytes; elongated intercellular bridges

Answer 39

Spongiosis